| NPI | 1326509894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A179042) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 897) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-01-28 |